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Although I have left the discussion of pregestational diabetes until the end of our series on “Diabetes in Pregnancy,” that was not done with the intent of diminishing its significance with regard to maternal and fetal morbidity and mortality. Ev...

Routine Screening for HIV During Pregnancy

Last week I was asked to represent our hospital system at a conference sponsored by the Centers for Disease Control (CDC) regarding “Implementation of HIV Screening in Acute Care Settings.” Several of the larger hospitals in the southeast were re...

These readers' comments/questions touch on a variety of issues of general interest - severe cervical dysplasia in pregnancy, protein S deficiency in a woman who lost a pregnancy at 24 weeks, and recurrent miscarriages associated with different chr...

Postmortem Postscript: Staphylococcal Pneumonia

About a month ago, I posted a note ("It was the best of times, it was the worst of times...") about a mother's death the day following her delivery. Although she had had a fever in labor and after delivery, and had been started on broad spectrum a...

Thank you Dr. Anonymous

Dr. A,Thank you for including my Poignant Story post in your Grand Rounds this week. Mine wasn't the only 'poignant story' and the overall impact of this weeks' content is a refreshing change of pace. My compliments on the format and for trying so...

Risk of Amniocentesis

Today I saw a 38 year old woman who came for genetic counseling and possible amniocentesis to rule out a fetal chromosomal abnormality. She was right at 16 weeks’ gestation. Her last pregnancy was 18 years ago and the 47 year old father of the cur...

Intrahepatic Cholestasis of Pregnancy - A Bitch of an Itch

Recently, we had a woman diagnosed late in pregnancy with intrahepatic cholestasis of pregnancy, or obstetric cholestasis (OC). Despite reassuring fetal heart rate testing, the baby died in utero awaiting induction of labor that had been schedule...

Thanks for the Oscar Nomination Dr. Jake: Grand Rounds 3.22

Many thanks to Dr. Jake Young and the Pure Pedantry team for including my post from December 3, 2006, entitled "The Human Value of Knowledge" in their Oscar line up of this week's Grand Rounds 3.22. I am so happy, I think I will go out and shave ...

Quintuplet Story - A Physician's Perspective - 3

...The following day, I had a long discussion with Joy and Andres about what to expect over the next 3-4 weeks, the discomforts, the psychological drain, the ever-present concerns for outcomes and the risks. The uterus is now the size of a term o...

Recurrent Early Pregnancy Loss - 9 - Evaluation

When I first see a patient in consultation for recurrent early pregnancy loss, I usually spend at least an hour with them. The first part of the appointment is spent in obtaining a detailed history – medical, social, and family. Since many diffe...

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